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Submuscular/subglandular/subfacia breast augmentation. What are the differences?

Hello, I have seen two doctors to consult about breast augmentation. Both of them had two techniques they recommended. The first one advised a subpectoral/subfacia and the second advised a subglandular. I have read so much about it and learn that there are pros and cons for all different placement of the implants. I really want to get it done but need to have more knowledge about it. I'm 5'6 130lbs. I also run and lift weights. What do you recommend? Thank you!

Both Dr. Baxter & Dr. Seckel give very good explanations of the differences between techniques. Other things to consider are how much breast tissue you have, the position of your breasts on your chest (sagging), and the type and size of implant you are considering.

A woman with C cup breasts and some sagging who is planning on 350 cc gel implants may be OK with a subglandular technique. However, a woman with A cup breasts who wants 450 cc saline implants would be better off with submuscular implants.

An experienced plastic surgeon will select the technique best for each individual patient. But in some cases, there is no one "right answer". Consider asking each plastic surgeon why they recommend what they did and why not the other technique.

Karol A Gutowski MD

676 N St Clair StChicagoIL60611US

Karol A Gutowski MD

676 N. St. Clair Street,15th Floor, Chicago, IL 60611, USA

ACTIVE MEMBER

There are many advantages to placing the implant beneath the chest muscle, Most noticeably less chance of capsular contraction, better coverage of the implant and better mammograms in the future, Most vigorous exercise patients like the additional support provided by the muscle.

Sub-fascial placement of a breast implant does place the breast implant above the muscle and beneath the breast. However subfascial breast augmentation is different from Sub-glandular or sub-mammary breast augmentation. Sub-glandular breast augmentation places the implant beneath the breast gland but on top of the muscle and muscle fascia.

Subfascial breast augmentation places the implant beneath the fascia a thick membranous layer covering of the pectoralis muscle. Therefore the implant is still beneath the gland and on top of the muscle but has an extra layer, the fascia covering the implant. Many plastic surgeons feel this improves support for the implant and leads to fewer capsular contractions than simply placing the implant under the breast. However the technique is difficult, there is extra bleeding, and often the fascia is torn which essentially converts the implant to the submammar location.

However, sub-muscular implant, placing the implant beneath the muscle is a technique preferred by most plastic surgeons today. Placing the implant under the muscle provides better coverage of the implant and in my opinion significantly reduces the chance of capsular contraction.

The fascia is a thin layer of connective tissue on the surface of the muscle; subfascial means lifting it off of the muscle so that it is between the implant and the breast. It is similar to subglandular but with this extra layer of support. It does not add much in the way of coverage however, and most patients benefit from the extra coverage provided by the muscle. The split muscle/subfascial technique is a compromise between these 2 methods. It places the upper part of the implant under the muscle, but leaves the lower part of the muscle behind the implant rather than detaching it as is done with the dual plane subpectoral method. This approach is advantageous for body builders and athletes because it gives coverage where it is needed but preserves muscle function and minimizes animation deformity.